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THE TREATMENT 



OF 



NERVOUS DISEASES 



ELECTRICITY 



A REVIEW 

OF THE PRESENT EXTENT OF ELECTRICAL TREATMENT, WITH 
INDICATIONS FOR ITS EMPLOYMENT 

By Dr. FRIEDRICH FIEBER 

Instructor at the University, and Chief of the Special division for Electro* 

Therapeutics and Inhalations [diseases of the nerves, chest 

and throat), of the K. K. Hospital of Vienna 



TRANSLATED FROM THE GERMAN 
BY 

GEORGE M. SCHWEIG, M. D. 

Member of the New York County Medical Society, etc. 

\ 

NEW YORK 
G. P. PUTNAM'S SONS 

FOURTH AVENUE AND TWENTY-THIRD STREET 
1874 



7?Ajm 






,F5 



Entered according to Act of Congress, in the year 1874, by 

G. P. PUTNAM'S SONS, 
In the Office cf the Librarian of Congress, at Washington. 



TRANSLATOR'S PREFACE. 



I SUPPLY a want of my profession by the trans- 
lation of the following clever monograph. The 
eminent benefits conferred on mankind by the in- 
troduction of electricity into therapeutics are so 
evident, that this branch of treatment is making rapid 
advances, to the gradual exclusion of inferior reme- 
dies in the respective pathological conditions. It 
therefore becomes desirable that every physician, 
whether he apply electricity personally or not, should 
be informed as to its uses, and the indications for its 
employment in special cases, that he may be able to 
fulfil the first duty of his art — to order the most 
appropriate remedy to each case. 

Gentlemen who do not make the application of 
electricity almost or quite a specialty, have no strong 
incentive to study the more voluminous treatises on 
the subject, nor is it necessary that they should. So 
far as the welfare of their patients is concerned, it is 



4 TRANSLATOR'S PREFACE. 

enough to know when and where electricity may be 
used with benefit ; and a brief and comprehensive 
review like the following, which may be read through 
in an hour or two, showing the principal conditions 
where this comparatively new remedial agent has 
been successfully employed, gives all the information 
needed. The purpose of the author in publishing his 
essay may best be gathered from the text itself. 

G. M. S. 

1 60 Second Avenue, 
New York City, October, 1874, 



N r EURO-THERAPEUTICS, like the art of 
which it is a branch, is a science based on 
experience. Its principles spring from the careful 
observing of a large number of cases of disease, and 
can be best understood by those who have a pro- 
portionate number of such cases at their command. 
Whoever has the opportunity of extensive observa- 
tions of the kind, may not only find in it the justifi- 
cation of publishing his views, but an obligation to 
present them to the profession for the furtherance 
of both scientific and humanitarian progress. 

As my cases for some years past may be num- 
bered by tens of thousands, I believe I may claim the 
right to offer an opinion on the treatment of nervous 
diseases. 

I have chosen for my subject the employment of 



6 TREATMENT OE 

electricity in nervous diseases (" electrization," as 
electro-therapeutics is popularly termed, and by 
which the non-professional public understand nearly 
every possible thing), for several reasons. In the first 
place, because the science of electro-therapeutics has 
of late made rapid and steady progress, and this I 
consider it useful to point out from time to time ; in 
the second, it may check the frequently inappropriate, 
and therefore useless, if not injurious, modes of elec- 
trical applications by unskilful hands ; and lastly, on 
account of the many and not insignificant prejudices 
against electricity. 

As to the progress that the application of elec- 
tricity in disease is constantly making, several direc- 
tions of this may be distinguished. In the first place, 
electricity has favorably influenced general thera- 
peutics, inasmuch as that electrical treatment has 
supplanted methods that were not exactly in conson- 
ance with refined tenderness, although, according to 
former conceptions, they may have been part of the 
cruel necessity of science. Thus, I still remember 
having witnessed, some years since, the application of 
the actual cautery in so called tabes dorsualis, 
until the skin was burned along the entire length of 
the spine. This procedure of course did not the 
slightest good, but at that time the extraordinary 



NERVOUS DISEASES. 7 

effects of the electric, and particularly of the galvanic 
current were not as well known as now. Hence it 
was that many physicians regarded tabes dorsualis 
as a disease that forbade all medical interference, and 
looked to nature only for its cure. At the present 
day this is not the case quite so often, as most physi- 
cians may justly claim the privilege of untiringly 
following up the advances of the several specialties in 
therapeutics. 

A further acquisition of electro-therapeutics may 
be found in the facts that the indications for the 
special modes of application of the electric current 
continue to become more sharply and clearly defined, 
and that the " electrization " can be carried out more 
in accordance with fixed standards, by reason of which 
the entire proceeding gains essentially in regard to 
safety as well as success. 

It may thus be determined with a certain degree 
of precision in rheumatic facial paralysis, when to 
employ the galvanic, and when the faradic current ; 
when we may expect some good from one of these 
two varieties of electricity, while from the other we 
can hope nothing. 

A further progress in electro-therapeutics may be 
found in its influence on the expansion of our knowl- 
edge of disease itself. From the nature of the sue- 



8 TREATMENT OE 

cessful remedy and the manner in which it acts, we 
draw conclusions as to the nature of the disease that 
has been cured, and in this respect it is, among others, 
especially the electrical treatment of the sympathetic 
system that admits of such deductions. Thus I have 
been enabled solely by this means to trace back the 
nature of intermittent fever, at least in a large number 
of cases, to an affection of the sympathetic (neurosis 
sympathici). This mode of deduction can be still 
further pursued, and from the fact that in a large 
number of cases intermittent fever has proven an 
affection of the sympathetic system, it may be in- 
ferred that quinia, our most trustworthy remedy in 
intermittents, stands in special relation to the sympa- 
thetic nerve (resembling the relation that we observe 
between ergot of rye and the female generative 
organs). In this case electricity would have served 
not only to explain the nature of a disease, but like- 
wise the relations of a certain other remedy to an 
important organ. 

A further advance in the medical application of 
electricity consists not only in the fact that the knowl- 
edge of the laws governing its employment in certain 
pathological conditions is constantly increasing (as 
has already been stated), or, to quote the poet, " we 
have descended to the depth in which we find the es- 



NERVOUS DISEASES. 9 

sence," but that we have also greatly enlarged the 
limits of its applicability. 

The employment of electricity has, at the present 
day, been extended to so great a number of diseases, 
and the boundaries of its sphere are expanding in a 
manner so constant and fertile, that a short time since 
scarcely anyone could have even approximately formed 
an idea of the possibility of this expansion. Not only 
has the employment of electricity in medicine long 
since overstepped the limits of nervous disorders, 
where (acute cases excepted) it is almost universally 
employed ; so that, in addition to nervous diseases, we 
see rheumatism, inflammations and swellings of joints 
etc., drawn within the sphere of its usefulness ; but it 
has manifested its extraordinary influence also in 
affections that seemingly lie entirely beyond its range. . 
Thus it is certainly something wonderful to behold in 
electricity (aside entirely from galvano-cautery) a 
certain means for the removal of cancerous and other 
tumors. 

I purpose however to point out not only the 
great and constant advances made in electro-thera- 
peutics to which these lines owe their origin, but, in 
contradistinction thereto, the oftentimes entirely in- 
appropriate manner in which the different varieties of 
the electric current are gratuitously selected in 



io TREATMENT OE 

obedience to accidental extrinsic circumstances, their 
employment corresponding to anything but the laws 
of therapeutics. Thus it may be frequently observed 
that rheumatic facial paralyses are treated by the 
faradic current, even when the faradic irritability has 
long since disappeared (and the result of attempts of 
this kind is of course nought), in place of easily 
obtaining muscular contractions by the use of the 
galvanic current ; or, a patient suffering from " tabes 
dorsualis " is treated by the same faradic current, and 
the strength of the already hypererethic muscles is 
still further exhausted, to the greatest injury of the 
patient. Not infrequently the occasion for such a 
proceeding is the lack of a galvanic battery, in which 
case it would of course be better to dispense alto- 
gether with electrical treatment. Not so very long 
ago, electrical treatment was carried out by simply 
giving the patient a pair of handles to hold in his 
hands, the electric current thus traversing the whole 
body, no regard being taken to the seat of the disease. 
That the nature of the current — whether galvanic or 
faradic — its strength and the duration of its appli- 
cation, were little considered in this proceeding, needs 
scarcely to be remarked. I must observe, however, 
that the reproach of instituting such absurd proceed- 
ings falls less on physicians than on patients them- 



NERVOUS DISEASES. n 

selves, which latter frequently content themselves 
with purchasing a faradic apparatus from some 
manufacturer, setting it to work, and then " electrify- 
ing " away. It has even come to my knowledge, 
incredible as it may appear, that here in Vienna 
people have gone to the " Prater," taken a few shocks 
from a frictional electricity machine in some booth, 
and were afterwards very much surprised that the 
"cure" was not followed by the desired result. It is 
true such glaring absurdities are the exception, but 
the bare fact that they can occur at all, proves that 
general education, especially as regards conceptions 
of the preservation and restoration of health, on the 
whole does not as yet occupy very advanced ground. 

This deplorable condition of things also favors the 
more or less mysterious doings of charlatans of 
every kind, and their invasion of the territory of 
medical electricity. Quackery naturally finds its most 
fertile field where conditions come into play that are 
not very clear, and as, among the disorders of the 
various systems of the human body, it is precisely 
affections of the nervous system that offer greater 
obstacles to exact research than almost any other 
class of diseases, the imperfectly raised veil of this 
pathological picture of Sais is well adapted to afford 
the desired screen to doings that shun the light. 



12 TREATMENT OE 

This is the more to be regretted in that not only is no 
relief obtained in individual cases, but electro-thera- 
peutics is disparaged in a manner generally detri- 
mental in the eyes of the non-medical — and even of a 
portion of the medical public, who, under the name of 
" electrization," identify procedures of this kind with 
a scientific mode of application. Whosoever then 
does not maintain an opposition to the laws of logical 
thought, should, when he hears of pretended unfavor- 
able results of an " electrical treatment," ask himself 
first of all, whether this treatment was administered 
by a skilled or unskilled hand. 

In discussing the judiciousness or injudiciousness 
of a method of electrical treatment, consideration 
should be had to the fact that electricity is frequently 
employed at an unsuitable period ; sometimes too soon, 
.much more frequently, however, too late. When all 
other modes of treatment have been tried and have 
failed, then the electric current is appealed to, in 
order if possible to perform miracles ; and in some 
instances surprising results, approaching the miracu- 
lous, are indeed obtained. In a large number of cases, 
however, the " Too Late " of Cremieux, big with fate 
not only in the political, but also in other domains, 
maintains its rights ; and disorders that, in the first 
stage of their development, had yielded readily to 



NERVOUS DISEASES. 13 

electrical treatment, are at later periods unamenable 
to its influence. 

I come now to speak of the prejudices which here 
and there are still current among the laity, although 
among the greater portion of the educated classes 
they may be considered as having been long since 
outlived. 

In the first place, many persons do not know that 
there are various kinds of electric currents, not all of 
which are applicable in medicine. Naturo-historical 
knowledge is unfortunately but very sparsely sown, 
and where found is often imperfect, which is perhaps 
less desirable than its entire absence. By far the 
greater number of patients are cognizant of but one 
kind of electricity, viz. : frictional electricity, which 
is generated by the so-called electric machines. 
Almost everybody has seen such a machine, with its 
revolving glass disk, and many have afforded them- 
selves the doubtful pleasure of taking a shock from 
one of them. Such patients then look upon every 
electric apparatus as a machine that dispenses 
shocks, and believe the entire electrical treatment 
to be a succession of such shocks ; a sort of electro- 
flogging, to which they have to subject themselves 
by way of penance for some sin or other, and which 
they look forward to with more or less dread. — Is 



i 4 TREATMENT OF 

the assurance needed that these apprehensions are 
groundless? It is not frictional, but galvanic and 
faradic electricity that at the present day are em- 
ployed in medicine, and it is a matter of course that 
every physician who is familiar with the application 
of the electric current, will let this act only in such a 
manner, that the patients can bear the treatment with 
ease and without the least inconvenience. I at least 
have never had to contend against any opposition to 
electricity on the part of patients after these had once 
obtained a knowledge of the character of the remedy. 
Even children, where they had arrived at a period to 
make some use of their intelligence, lost all dread of 
the current. Thus, not long since, I attended a girl 
about twelve years of age (the patient of Dr. M. 
Schlesinger, of Vienna), possessed of great nervous 
irritability, who at the commencement of the treat- 
ment escaped from the room containing the electric 
apparatus, and who after a time became so well 
reconciled to the applications, that currents of 
considerable intensity were borne with ease. 

The fear of pain, shocks, convulsing of the body, 
and whatever else may be the phantoms of an 
imagination led astray by a deficiency in naturo- 
historical knowledge, is entirely without foundation, 
provided the treatment is conducted by a physician 



NERVOUS DISEASES. 15 

familiar with electro-therapeutics. It can become 
realized only when the electrical treatment is carried 
out by one who is either not at all or only imperfectly 
conversant with the subject. As everything else, so 
electricity also can be abused. 

Another prejudice that frequently stands in the 
way of electricity is the strange idea that the electric 
current excites and irritates the nervous system. A 
very remarkable assertion indeed ! There is scarcely 
a single remedy by means of which hypererethic con- 
ditions, from simple irritability of every degree, to the 
most violent tic douloureux or other neuralgic pain, can 
be removed with so much certainty as by electricity. 
All depends of course on the manner of making the 
application, and it is here more especially that all 
holds good that I have said in regard to the painful- 
ness of the current. In the case of a lady, the patient 
of Professor Kainzbauer, who was subject to periodic 
violent attacks of excitement, a single stroking over 
the cervical sympathetic plexus of nerves was suffi- 
cient to give instant relief. 

A mode of treatment which is capable of abrogating 
with such rapidity an already existing state of violent 
excitation, cannot certainly be reproached with being 
itself of an exciting nature. 

A further error, very widespread among the 



16 TREATMENT OF 

public, consists in the confounding of electricity 
with animal magnetism, and there are many who stig- 
matize physicians making frequent use of the electric 
current as "magnetizers." It need hardly be observed 
that animal magnetism is, as its name is sufficient to 
indicate, something entirely different from the elec- 
tricity generated by galvanic batteries and faradic 
apparatus, as well in physical as in all other respects. 
Another prejudice against the employment of elec- 
tricity in therapeutics entertained by some, consists 
in the belief that electricity gives temporary relief, 
but does not cure disease ; or, that in conditions of 
debility for example, a transient stimulation is 
obtained, which is followed by a proportionately 
greater degree of relaxation. It requires scarcely to 
be stated that both these views are entirely imagin- 
ary. As to the thoroughness of the cure, modern 
pathology teaches us to trace back to the nervous 
system a great number of diseases, and there is 
scarcely to be found a single remedy that acts more 
directly and intensely on the nervous system than 
electricity. To this fact is due the success, often 
bordering on the miraculous, that in so large a number 
of cases is obtained by the application of electricity. 
As to the momentary excitation, said to be followed 
by a relaxation so much the greater, such need not be 



NERVOUS DISEASES. 17 

feared from the judicious employment of electricity, 
but at worst from its misapplication, as everything is 
subject to being misused. 

The prejudices and erroneous opinions under 
consideration are to be found, however, as heretofore 
remarked, almost if not quite exclusively among the 
laity. In the medical world — with some few insig- 
nificant exceptions — views in accordance with the 
advancement of science have long since obtained 
a foothold, as I have personally had and continue 
to have occasion to observe from the great number 
of patients sent me from far and near for electrical 
treatment. 

The more general character of the present treatise 
does not admit of the dwelling at length upon special 
forms of disease, and I will therefore content myself 
with discussing briefly the principal varieties, and to 
treat more minutely of one or other of them only. 

The great territory of paralyses and pareses of 
every kind is that in which above all others the elec- 
tric current has for many years past found employ- 
ment in a manner more or less appropriate, and this 
comes indeed pre-eminently within its domain. Not 
that electricity is less efficacious in other forms of 
disease ; but in paralyses it is to some extent the sole 
remedy, because other methods of treatment, with few 



1 8 TREATMENT OE 

exceptions, do not in the remotest degree approach it 
in point of efficiency. 

As I do not intend in the present essay, which is 
to be as concise as possible, to enter into details, for 
which I must refer the reader to my " Hand Book of 
Electro-Therapeutics " (Vienna, 1869, Braumliller, 
court publisher), as well as to numerous articles in 
scientific domestic and foreign journals, I cannot 
dwell minutely on the manifold varieties of paralyses 
and pareses that find in the application of electricity 
their most trustworthy, and very frequently their only 
remedy. I must rather limit myself, in accordance 
with the object of these lines, to enumerating the 
different varieties of paralysis, and, with the exception 
of a few brief remarks, to point out especially that 
which we are justified in recognizing as progress in 
the method of electrical treatment belonging to a 
recent period. 

It is well known that among paralyses and pareses 
we distinguish those that have their origin in the 
brain or spinal cord (known as central), and others 
that originate in a mere local affection of the parts in 
in which they occur {peripheral). Of the central 
paralyses, those proceeding from the brain (through 
cerebral hemorrhage, tumors, embolism, or intra- 
cranial inflammatory processes), were more particularly 



NERVOUS DISEASES. 19 

held to be above all others best left to themselves, and 
I will not deny that I also was formerly wont to con- 
tent myself in most of these cases with electrizing the 
palsied arm or leg, while I often hesitated to let the 
electric current act on the brain directly. As among 
the thousands of cases of nervous disease that have 
come under my observation, brain affections were 
numerously represented, I have had ample opportu- 
nity to enrich my experiences in this respect, and 
based on these, I proceed not infrequently, and with 
the observance of the proper precautionary measures, 
to the direct electrical treatment of the brain. I re- 
call among others a case sent me by Professor 
Duchek, in which the great sensitiveness of the 
patient notwithstanding, the electric current, em- 
ployed with proper precaution, was very well borne. 

At the same time the electrical treatment of the 
paralyzed arm or leg must not of course be neglected, 
because otherwise the protracted (frequently for 
months and years) functional inactivity of the para- 
lyzed parts may finally bring on muscular atrophy, 
and the use of the limb become very questionable 
from this cause alone. 

The chapter of spinal paralyses and their electrical 
treatment would, if exhaustively treated, fill volumes, 
and volumes have indeed been written on the subject. 



20 TREATMENT OF 

So much has however been accomplished, that 
physicians who stand high in point of science 
have ceased to class spinal paralyses, the so-called 
traumatic spinal paralyses — paralyses strictly speak- 
ing — as well as the disturbances of co-ordination 
proceeding from the well-known affections of the 
posterior columns of the spinal cord, commonly 
termed "locomotor ataxia" {tabes dorsitalts), and the 
resulting inability to walk and to stand, among the 
affections before which the healing art stands with its 
hands tied. It is on the contrary exactly in these 
forms, and particularly in tabes dorsualis, that the elec- 
tric current renders excellent service, and stands first 
among all the remedies that are employed against 
the affection in question. With all due modesty I 
must say that my assistant physicians and I may 
count it as a not inconsiderable merit in the cause of 
suffering humanity, that we have, in the course of years, 
enabled a very large number of such unfortunate para- 
lytics, who sought help in my special department of 
the imperial royal hospital, and in whom the misfor- 
tune of poverty was superadded to the disease, to 
make use of their limbs once more in a more or less 
perfect degree, and that many a one who was brought 
into the sick room on a litter, was enabled to leave it 
on his own legs. 



NERVOUS DISEASES. 21 

The latest advances in pathology have contributed 
materially towards clearing up the relations of the 
sympathetic nerve to that terrible disease that we 
know 7 and dread under the name of progressive mus- 
cular atrophy {Atrophia muscul. progress) As we 
possess at the present time no remedy by means of 
which we can influence even to a degree the sympa- 
thetic system, except the electric (galvanic) current, 
and as we likewise have no other means to effect, even 
approximatively, contractions, and thus a sort of pas- 
sive gymnastics, of the affected muscles, no further 
commendation is needed for any one who has watched 
but a few cases even of muscular atrophy, which con- 
verts the strong arm and the vigorous body into a 
fleshless skeleton. 

It is to be explicitly understood in this place, how- 
ever, where the question is not one of exalted thera- 
peutic fancies, but rather of the results of sober obser- 
vation (which, although elsewhere generally, is here 
particularly, necessary), that we are rarely able to give 
back its original fulness to the muscle that has once 
degenerated from its integral condition, but must con- 
tent ourselves on the one hand with arresting the 
progress of the disease, on the other w T ith exalting 
to the highest degree the activity of the still intact 
muscular fibres. But in doing even this we accom- 



22 TREATMENT OF 

plish a great deal, because we are then not unfre- 
quently enabled to check also the violent pains ac- 
companying the atrophy. Ordinarily these pains, 
which nature seems to send as a warning to those 
afflicted, are misconstrued and looked upon as rheu- 
matic, until the rapid emaciation brings to light the 
true character of the disease. Not unf requently the 
proper moment for the commencement of the electri- 
cal treatment, which here should be initiated as early 
as possible, is let slip, and it is altogether much to be 
regretted that as a rule electricity is had recourse 
to only when all medicaments, cold water cures, 
other bath cures, a legion of domestic and secret 
remedies etc. have been already and unavailingly em- 
ployed. When a series of unsuccessful therapeutic 
efforts have destroyed both the courage and confidence 
of the patient, and the disease has reached its climax — 
then only electricity is called upon, like the triarians of 
ancient Rome, to advance against the enemy and con- 
quer the disease. It is surely a proof not to be un- 
dervalued of. the mighty power of the electric current, 
that by means of it we are enabled even under such 
unfavorable conditions to accomplish important re- 
sults. These would however be still greater and 
more complete were the remedy employed when 
the disease has not yet reached its height and the 



NERVOUS DISEASES. 23 

organs have not yet suffered so deeply as is the case 
later on. 

I think I may be permitted in this place to ask : 
Why is it that all those physicians who, with respect 
to the diagnosis as well as the therapy of disease, 
stand highest among the profession, place electricity 
in the first rank among remedies for nervous diseases, 
so that so celebrated a clinical physician as Griesinger 
has pronounced electricity an invaluable remedy ? * 
The reason for this may, we believe, be sought in that 
the process of the development of electricity (particu- 
larly of galvanic electricity) may be counted among the 
most sublime processes of the inorganic world that we 
know of, so that I have termed it — as I believe, not 
unjustly — in my inaugural lecture at the University 
of this city, a species of " inorganic life " (excuse the 
contradictio in adjectd). At all events the process 
of the development of galvanism is one that in many 
respects reminds one of that which presumably takes 
place in nervous life, although research in this direc- 
tion has not yet gone beyond the bounds of mere 
conjecture. 

Paralyses due to chronic poisoning, such as are 



* Eulenburg and Guttmann : " The pathology of the Sympathetic." 
Berlin, 1873. Hirschwald. (Preface, p. iii.) 



24 TREATMENT OF 

wont to occur from mercury, lead, arsenic, and verdi- 
gris, likewise find in the electric current a valuable 
remedy. Akin to these forms are the paralyses fol- 
lowing acute constitutional diseases (typhoid fever, 
small pox, diphtheria etc.*), and some chronic affec- 
tions (syphilis, rhachitis, osteo-malacia, scrofulosis, et. 
al) which to a certain extent are due to poisoning by 
organic matter. I have at the present time under 
treatment a highly interesting case of disturbance 
of speech (aphasia) following small pox. 

If it be indubitable that the healing art of the 
present day (and especially electricity) is capable of 
giving relief in at least a great proportion of the so- 
called central paralyses, those which proceed from the 
brain or spinal cord, it appears obvious that this must 
be the case in a much greater degree in the so-called 
peripheral paralyses, that have their cause merely in 
the spot where the paralysis manifests itself — i. e., 
within a more or less circumscribed area. I will state 
briefly only the several forms in which the electric 
current renders such excellent service. Before doing 
so, however, I will touch upon still another form of 



* I obtained a very good result in paralysis following diphtheria, 
in a case referred to me by privy councillor Von Schmerling, by 
using galvanism and faradization combined. 



NERVOUS DISEASES. 25 

paralyses, to which, according to the present state of 
science, a fitting place can scarcely be assigned. I 
allude to hysterical paralyses. 

Hysteria (derived from the greek varlpa y the 
womb) is not, it is true, to be treated from this " one 
point " only, as our celebrated Faust poet maintains ; 
but this too fruitful source of innumerable complaints 
must yet receive the first consideration. Fortunately 
we are able to act very decidedly also on the female 
generative organs by means of the electric current, 
and thus electro-therapeutics affords us the certainly 
very estimable advantage of influencing very energet- 
ically, by means of the same powerful agent, the source 
of the complaint as well as the nerve-tracts in which 
the reflex symptoms appear, the centre as well as the 
periphery. 

Probably every physician who sees much of ner- 
vous disease has among his patients a large number 
of hysterical ladies, who, as a general thing, designate 
their affections as " nervous/' so that in the mouth of 
the non-medical public the expressions " nervous " 
and " hysterical " are apt to mean to some extent the 
same thing. With this identification, which was former- 
ly still more en vogue than is the case at the present 
day, was connected what for those concerned proved a 
very deplorable error, which even at the present day 



26 TREATMENT OF 

occurs now and then, and against which a very deci- 
ded stand must be taken. The error in question is 
that, strange to say, the often insupportable sufferings 
of such unfortunate women and girls were held to be 
"fancied," looked upon as the phantoms of an over- 
excited imagination. The usual remedy consisted in 
" diversion " and the advice to exercise as much self- 
command as possible. This was based upon the view 
that the disease consisted in nothing but a change- 
able humor, while a thorough arid sufficient searching 
for the cause was dispensed with. In this respect 
modern practice has done justice to a great number of 
much-complaining though generally patient and en- 
during patients, by treating them with suitable reme- 
'dies, among which electricity occupies the first rank, 
instead of giving them reproaches and admonitions. 
This holds good not only of the paralyses and pa- 
reses occurring in hysterical women, but also of other 
forms of nervous affections; of spasmodic or neu- 
ralgic conditions and (in contradistinction to these) 
of the diminution of normal sensibility even to an- 
aesthesia. 

Peripheral paralyses are of varied import, accord- 
ing to the locality in which they occur. In all forms 
and whatever their location, among the various reme- 
dies electricity stands first. 



NERVOUS DISEASES. 27 

Paralyses of the muscles of the eye, which, by 
reason of the diplopia and the dizziness not unfre- 
quently resulting from this, inspire the patient with a 
great deal of fear, are often removed with surprising 
rapidity through galvanic electricity, by inducing reflex 
muscular contractions. Thus I call to mind a woman 
(a patient of Professor Kainzbauer),who suffered from 
a complete paralysis of the oculo-motorius. The 
upper eyelid hung down flaccid, the three recti 
muscles supplied by the motor oculi were absolutely 
incapacitated. Galvanism cured the affection com- 
pletely. 

A paralysis of the external rectus muscle, of inter- 
est by reason of the manner in which it was produced 
(the patient, a Pole about forty years of age, had, in a 
fit of rage, rolled the eye violently outward, and was 
subsequently unable to move it in that direction), dis- 
appeared under the influence of the faradic current. 
I have however observed, in paralysis of the external 
rectus muscle of the eye, excellent results from the 
galvanic current also ; thus recently in a case referred 
to me by Professor Von Arlt. Paralysis of the interior 
muscles of the eye I have also seen to disappear after 
galvanization of the sympathetic nerve, so far as a 
disappearance of the respective functional disturbances 
warrants a conclusion to that effect. The same holds 



28 TREATMENT OE 

good of the muscular fibres that regulate the size of 
the pupil. 

Paralyses of the face, which in the majority of 
cases are of rheumatic origin, are among the forms of 
disease that inspire with not a little terror those 
afflicted by them. And truly, the impossibility of 
closing the wide-open tearful eye, the discharge of 
saliva from the half-open angle of the mouth, the 
marble-like immobility of the entire side of the face, 
on which the patient is unable to - smile, to point the 
lips or puff out the cheeks ; where speaking and 
deglutition are impeded (not to speak of the great 
deformity), are calculated to inspire the layman with 
great concern. Fortunately it is exactly here that 
the electric current, especially (and often exclusively) 
the galvanic current, is of immense benefit, only this 
form more particularly requires a thorough compre- 
hension of the method, in order not unavailingly to 
subject the patient to faradic currents that are fre- 
quently without effect, and thus to neglect the em- 
ployment of galvanism. One of the most ag- 
gravated cases of unilateral facial paralysis, * among 



* Difficult confinements are sometimes followed by facial paralysis, 
as I have repeatedly had occasion to observe. 



NERVOUS DISEASES. ? 9 

the many patients of the kind whom I have attend- 
ed, occurred in the person of an Italian court lady, 
who was referred to me by Professor Von Sigmund, 
and who was completely restored by the use of elec- 
tricity. 

Paralyses of the tongue, when not of central origin, 
readily yield to the electric current, and one of the 
chief causes of troublesome disturbances of speech 
and of swallowing becomes thus removed. The same 
is true of the occasionally very aggravated par- 
alyses of the palate, that not unfrequently follow diph- 
theria. 

The electrical treatment of paralyses of the muscles 
of the larynx, which, in my laryngoscopic hospital as 
well as private practice, I have very frequent occasion 
to employ, is probably one of the most gratifying of 
the various utilizations of electricity. An attainment 
in therapeutics is best estimated retrospectively, by 
recalling the period when it was not available. I 
therefore dispense w r ith citing individual from among 
the many cases of paralysis of the vocal cords that I 
have treated, and will make mention of only one case, 
in which the electrical treatment of such a paralysis, 
at that time not recognizable for w r ant of the laryng- 
oscope, would in all likelihood have saved a human 
life. 



3 o TREATMENT OF 

It was in the years of my studentship, that at one 
of our mineral springs I met a gentleman who suf- 
fered from complete aphonia. The herculean frame 
of the patient spoke against any general tuberculous 
affection, a merely local inflammatory or even ulcera- 
tive process was excluded by the absence of all symp- 
toms (pain, cough, expectoration, etc.), while the 
absence of any difficulty whatever of respiration pre- 
cluded the assumption of a laryngeal tumor of any 
considerable size. A smaller tumor in the larynx 
would on the one hand have scarcely produced so 
complete an aphonia, on the other hand it would prob- 
ably in the course of years have grown larger. But 
when I saw the patient the affection had existed 
already several years, during which the symptoms had 
remained tolerably uniform. 

The likelihood that the trouble was nothing fur- 
ther than a paralysis of the vocal cords, was therefore 
not to be rejected. With a view to remove this affec- 
tion the patient had already been sent to springs in all 
directions, of course in vain. I was informed subse- 
quently that the sufferer, out of despair engendered by 
this persistent aphonia and the consequent impos- 
sibility of pursuing his avocation, had committed 
suicide. A case such as this is strongly illustra- 
tive of the importance of the advances made in 



NERVOUS DISEASES. 31 

diagnosis and therapeutics by specializing individual 
branches. * 

I will add a few words on the treatment of para- 
lyses of deglutition (paresis oesophagi). These mani- 
fest themselves by a difficulty or impossibility of 
swallowing, and are sometimes, when presenting 
themselves in a mild form only, overlooked in so far 
as that the phenomena are attributed to other patho- 
logical processes. The electrical procedure is as 
simple as it is certain. It consists in the exciting of 
deglutitory movements, by placing the one electrode 
(copper pole) on the nape of the neck, and with the 
other (zinc pole) stroking the neck (over the pomum 
Adami), which will at once be followed by energetic 
movements of deglutition. Of late I have modified 
this procedure, so that at first I excite deglutitory 
movements when the mouth is empty, while later on 
I incite and assist the deglutition of a bolus by means 
of the electric current, and in this procedure I gradu- 
ally weaken the current more and more, until finally 
swallowing becomes possible without its aid. In this 
manner I treated most successfully a girl eleven years 



* A highly interesting case of intermittent paralysis of the vocal 
cords that was characterized by alternate sonorous speaking and 
aphonia following it, was sent me by Prof. Von Loebel. A complete 
cure was effected by the use of the electric current. 



32 TREATMENT OE 

of age, the patient of Dr. M. Schlesinger, a case which 
I mention again especially because it goes to prove, 
like innumerable other cases, that even the most 
tender and timorous lose all dread of the electric cur- 
rent as soon as they have once become familiarized 
with it, and have become disabused of their pre- 
judices. The girl just mentioned, a nervous, some- 
what anaemic child, could at first be scarcely 
prevailed upon to approach the table by the side of 
which was placed the electric apparatus, and yet I 
succeeded in depriving the patient of all fear of the 
treatment she had so much dreaded. It cannot be 
too often repeated that the electric current, and this 
applies to the galvanic as well as the faradic, produces 
no shock and no pain nor any excitement of the nerv- 
ous system, provided the treatment be conducted by 
skilled hands ; for we possess in the various moder- 
ators, the gradual strengthening of the current, etc., 
means sufficient to avoid all disagreeable surprise to 
the patient. The electric current gives pain only 
when it is the intention of the physician to produce 
pain through its agency, i. e., to use it as a cutaneous 
irritant, in like manner as this is done by means of 
sinapisms and other cutaneous irritants. The pain 
produced by it is also more or less analogous to that 
produced by a sinapism, but is distinguished from this 



NERVOUS DISEASES. 33 

latter by the fact that under repeated electric irrita- 
tions of the skin the latter is left perfectly intact, and 
even the most delicate complexion remains unim- 
paired. 

In paralyses or pareses of the pectoral muscles — 
probably less often an idiopathic condition than one 
of the phenomena of general processes (especially of 
progressive muscular atrophy) — we possess in the 
electric current the most efficient remedy to combat 
the affection. It should not be forgotten to mention 
here the procedure recommended by some in pul- 
monary tuberculosis of obtaining an arrest of the 
disease by electrization of the respiratory muscles, and 
as the result of this an increased activity of the lungs. 

With regard to paralyses and pareses of the intes- 
tines, it is well known that in obstinate pareses of the 
muscidaris and the resulting peristaltic constipation, 
movements can readily be produced by faradization of 
the abdominal muscles. Galvanism, however, acts 
still more intensely, when, as I was first in Germany 
to publish a case in point, co-observed with me by 
Prof. Dittel, it is made to act directly on the rectum. 
In one case the constipation, which, after the fruitless 
employment of the strongest purgatives, made it 
necessary for weeks to evacuate the fecal masses me- 
chanically, yielded almost instantly to the influence of 

3 



34 TREATMENT OF 

the electric current. Among the long list of electro- 
therapeutic successes, the result obtained in this case 
may be counted among the most brilliant. 

Paralyses of the bladder, when not the result of 
central lesions, usually likewise yield readily to the 
influence of electricity — mostly faradic. Even in 
children, where pareses of this kind are usually at- 
tended with enuresis nocturna, it is very easy to 
apply electricity, it being necessary only to use a very 
mild current at first, which may be gradually made 
stronger. The little ones may thus be made to bear 
currents of considerable intensity with ease. In the 
vesical paralyses of adults, a co-existent moderate 
vesical catarrh constitutes no obstacle to the electrical 
treatment, provided this is instituted with the observ- 
ance of proper precautions. 

I have recently treated a patient from Hungary, 
referred to me by Prof. Dittel, with the faradic cur- 
rent, while a vesical catarrh accompanying the paresis 
disappeared simultaneously under the influence of the 
appropriate local treatment. 

Paralyses of the extremities, the upper as well as 
the lower, often afford a fine field to electricity. As 
to the pareses that are among the phenomena of dis- 
orders of the brain and spinal cord, of affections of the 
sympathetic nerves, of other acute and chronic consti- 



NERVOUS DISEASES. 35 

tutional diseases, and particularly of toxic conditions, 
they have already been spoken of. It needs only to 
be remarked here, that even where we do not succeed 
in curing the original disease with the desired 
rapidity, the electrical treatment of the paralyzed arm 
or leg appears very useful and necessary as a prophy- 
lactic against muscular atrophy. In peripheral par- 
alyses, as these occur from colds, as rheumatic, from 
external injuries (blow, thrust, fall, contusion, cut, 
stab, etc.), as traumatic (in which category are to be 
placed also the paralyses from fatigue consequent on 
over-exertion), wasting and muscular atrophy super- 
vene still more rapidly. The swiftest aggressions, 
how r ever, of paralysis and wasting, occur from articu- 
lar, and after these from neuralgic affections, both of 
which forms self-evidently impair motion. It is 
superfluous to point out the brilliant results obtained 
here by the electric current. They are so numerous 
that there are probably but few physicians who have 
not had occasion to personally observe, at least some 
one case of this kind. 

The importance of electricity in orthopaedics is 
too well known to render it- necessary to enter into 
details in this respect. In many cases of curvature of 
the spine, the arms and legs, protrusion of the scap- 
lae, etc., other treatment (different apparatus, gym- 



36 TREATMENT OF 

nasties) is appropriately aided by a suitable electrical 
treatment, and the re-establishment of the normal 
shape thus materially hastened, and sometimes ren- 
dered possible only through electricity. 

These brief observations are by no means ex- 
haustive in respect to the due appreciation of elec- 
tricity in view of its efficacy in paralysis. It is not 
my intention, however, to present in these lines an 
exhaustive treatise on electro-therapeutics, but mere- 
ly to sketch what is newest and at present the most 
generally adopted in the utilization of electricity in 
medicine. I therefore conclude the disquisition on 
paralyses and proceed to the discussing of the elec- 
trical treatment of spasmodic affections. 

The class of which we shall now speak is a large 
and important one. From the slightest transient in- 
voluntary contraction it extends in uninterrupted suc- 
cession to the severest attack of epilepsy and chorea. 
Here also (as in paralyses) we distinguish those spasms 
that have their cause in cerebral and spinal affec- 
tions ; then those that originate in the muscles where 
they manifest themselves, and finally those that are 
the result of reflex action from some point of the 
periphery on the centre. 

If I commence by discussing the electrical treat- 
ment of epilepsy, I can of course not deny that the 



NERVOUS DISEASES, 37 

present state of pathology has not as yet reached a 
point where the indications for the use of electricity 
in epilepsy would appear clearly defined, and some 
fixed method applicable to the majority of cases 
arrived at. As this disease, however, has unfortun- 
ately become very wide-spread — I at least have a great 
many such patients come to me for treatment in 
hospital- as well as private practice — it was rendered 
possible through continued experimenting empirically 
to arrive at an electrical procedure, which has done 
me good service and deserves the preference over 
other modes. This is the galvanic treatment of the 
sympathetic nerves, in regard to which one of my 
assistant physicians published some detailed commu- 
nications in a medical journal which bear testimony 
to the favorable results obtained. 

In chorea electricity has met with considerable 
success, and it is in the most aggravated forms 
especially of this disease that the electric current 
achieves its greatest triumphs. I will make mention 
here of only one vehement case, which I observed in 
a girl about thirteen years of age. There was 
scarcely a single muscle in the body of this child 
that was not violently agitated ; the head, upper and 
lower portions of the trunk, arms and legs were 
thrown in all directions ; the hair concealed from 



38 TREATMENT OF 

view to some extent the flushed face, which was 
covered with foam and sweat ; there was neither 
sitting, standing, walking or speaking, and deglutition 
was to some extent only possible. To this was super- 
added a psychical excitement readily comprehensible. 
The treatment was in accordance with my usual pro- 
cedure (galvanization of the spinal cord) ; the result 
was most brilliant. The girl, who was the daughter 
of an innkeeper at Mahren, was completely cured ; 
spasms and psychical excitement disappeared entirely ; 
sitting, standing, walking, swallowing and speaking 
were accomplished in a perfectly normal manner. 

In clonic spasms, where these do not occur in 
connection with conditions of general exhaustion, I 
have observed good results from galvanic as well as 
faradic electricity. 

As effusions of blood in the brain and other 
cerebral lesions lead to paralysis, so also do they give 
rise to spasmodic conditions and contractions of the 
most varied kind. In contractions that have been 
produced in this manner I am in the habit of adopt- 
ing a double procedure ; electrical treatment of the 
affected extremity, and cautious action on the cen- 
tre itself ; best by galvanization of the sympathetic 
nerve — observing, of course, the necessary precau- 
tions. 



NERVOUS DISEASES. 39 

I have pursued an analogous course in contrac- 
tions from spinal affections, while formerly both spas- 
modic affections were looked upon by some as an 
absolute noli vie tangere — an assertion that can no 
longer be unconditionally maintained in the present 
state of electro-therapeutics* 

Hysterical affections, as they lead to paralysis, 
may also lead to spasms in the greatest variety. Even 
though these from their very nature do not bring 
with them any great danger, they yet annoy the 
women affected in an extraordinary degree, and some- 
times lead to psychical affections of more or less im- 
port, which may, however, become developed in all 
forms of hysteria. For such nervous females, then, 
electricity presents a highly valuable remedy in two 
respects : not only does it enable us to combat the 
original disease, but it lies in our power also to 
diminish and abolish the spasms of individual mus- 
cles, partly by the constant galvanic current, partly by 
electro-cutaneous irritation; or by exalting the 
activity of the antagonists by faradic stimulation. 

I believe this to be the most fitting place to make 



* It follows as a matter of course that all central treatment must be 
dispensed with when we have to do with an intrinsically incurable 
affection of the brain or spinal cord, or of tissues surrounding these (as 
for instance a psendoplasma, aneurys7?ia etc.). 



4 o TREATMENT OE 

mention of a very remarkable case that I observed 
in my division. There were represented at one and 
the same time four different nervous diseases in a girl 
of twenty years of age. Besides a spasmodic contrac- 
tion of the upper arm (in. biceps), the patient suffered 
from chorea, nervous attacks of coughing and attacks 
of profound syncope, which, although calling to mind 
epilepsy, could yet not be designated as such, the 
patient presenting rather the picture of a person 
quietly sleeping, from which sleep, it is true, she 
could be roused by nothing. All four affections dis- 
appeared completely under the influence of the elec- 
tric current. 

Rheumatic affections also are to be placed among 
the forms of disease that, giving rise on the one hand 
to paralysis, on the other hand may originate spasms 
and contractions in the greatest variety. Of spasms, 
they are more particularly those of the face (so-called 
mimic spasms), spasms and contractions of the cer- 
vical and nuchal region, that produce obliquity of the 
head in various directions {torticollis) ; also spasms 
and contractions of the arms and legs which, when 
originating in this manner, can be removed more or 
less completely by electricity. 

A peculiar form is presented by the so-called 
"writer's spasm." This occurs at times in persons 



NERVOUS DISEASES. 41 

who, by over-exertion, have placed a certain group 
of muscles in a state of irritation, in consequence 
of which the phenomena of spasm appear in the 
fatigued arm. These spasms occur, however, not 
only as the consequence of over-exertion by writing, 
but also from long-continued exertion of the arm 
otherwise, as by playing piano, sewing, etc. The 
sooner electrical treatment is instituted in these 
cases, the more is of course to be hoped from it. 

Spasm of the voice (convulsive attacks of cough- 
ing with synchronous weakness of the voice, even to 
aphonia), nervous asthma, spasm of the heart (pro- 
ceeding from the cardiac plexus), spasm of the dia- 
phragm (which manifests itself by so-called hiccough- 
ing), nervous vomiting,* intestinal spasm (proceeding 
from the plexus mesentericus), all find one of the 
most excellent remedies partly in the galvanic and 
partly in the faradic current. 

I have in the foregoing lines dwelt upon the 
disturbances of motion with respect to where they 
manifest themselves as paralyses and general pareses, 
as well as where, in contradistinction, they take the 
form of spasms and contractions, and I now proceed 



* In two cases of nervous vomiting with synchronous cardialgia, I 
observed especially good results from the electric current. 



42 TREATMENT OE 

to sketch as briefly as the importance of the subject 
will admit, the influence of electricity on the disturb- 
ances of sensation. 

Of these also we distinguish two forms of morbid 
conditions ; a) Diminution of sensation extending to 
its entire absence (anaethesia) and b) Enhancement of 
the normal sensibility (hyperesthesia). 

Anaesthesia may affect either the skin alone 
(cutaneous anaesthesia), or it may extend deeper 
down to the muscular layers (muscular anaesthesia). 
In either case we may have to do with a merely local 
affection, or the seat of the disease may be more 
deeply situated ; in the brain, the spinal cord, or 
sympathetic system. Hysteria is also very frequent- 
ly accompanied with more or less anaesthesia. In 
all these affections electricity is in most of the cases 
a sure remedy, excelled or even equalled by none 
other — by means of which we are enabled to remove 
the different degrees of diminution of sensibility. The 
current is here directed partly to the nervous centres 
partly to their peripheral ramifications, and it is 
especially by electric irritation of the skin that we 
are sometimes enabled to obtain brilliant results. 

In the various forms of paraesthesiae (which are 
wont to be designated by the patients as "false, 
sensations"), electricity is an excellent remedy. It 



NERVOUS DISEASES. 43 

would lead us too far to attempt even approximately to 
describe these " false sensations ; " their name is 
legion ; nervous ladies can speak on the subject. 

I will here touch briefly only upon the influence 
of electricity on a few groups of diseases, which, 
although not strictly speaking, to be classed among 
anaesthesiae, are yet best treated of in this connection. 

Not only disturbances of sensation, but those of 
the special senses also have been successfully treated 
by electrical means. I have made specially interesting 
observations concerning the electrical treatment of 
the loss of the sense of smell (anosmia), and have 
here repeatedly succeeded in restoring the lost sense 
by the use of electricity. 

Electricity likewise plays an important part in the 
treatment of male impotency, of which particularly of 
late years numerous cases have come under my care. 
It is to be lamented that patients of this class 
sometimes apply for electrical treatment only after 
they have been experimented upon according to all 
practicable as well as impracticable methods, often by 
charlatans of the worst sort. Here also, as in most 
other affections, the rule holds good of initiating the 
electrical treatment as early as possible, and in the 
majority of cases, where no important structural 
changes (particularly atrophy) have taken place, a 



44 TREATMENT OF 

favorable result can be obtained. But even where 
the disease is already very far advanced and con- 
siderable changes have occurred, the hope of success 
is net by any means to be abandoned. In the am- 
bulatorium of my division I have observed a young 
man in whom all hopes of recovery appeared to have 
been abandoned, and yet the patient found occasion 
to acknowledge the beneficial influence of the elec- 
tric current. 

I likewise witnessed very good results in the 
case of a patient referred to me by Professor von 
Loebel, where, in the affection under consideration, 
I employed exclusively electric irritation of the 
skin. 

If electricity be justly extolled as a specific in 
nervous diseases generally, this holds good more par- 
ticularly of the electrical treatment of male impo- 
tency. Whosoever estimates properly the importance 
of this affection, where not unfrequently great in- 
terests are at stake, will also know how to value so 
excellent a remedy as electricity. 

As on the one hand sensibility may become 
diminished even to its entire extinction, so on the 
contrary it may become abnormally increased. This 
increase we know as hyperesthesia (excessive irrita- 
bility), and when this is accompanied by a painful 



NERVOUS DISEASES. 45 

sensation (strictly speaking) in distinct nerve tracts, 
as neuralgia. 

It is again hysteria which is not unfrequently 
accompanied by the most torturing hyperaesthesiac 
of every variety, and there is scarcely a part of the 
human, especially the female body, that is not 
liable to be thus attacked. We have here vague pains 
in the various nerve tracts, that manifest themselves 
in no fixed localities, hypererethism in different 
places, as of the joints, that may be increased to be- 
come unendurable pain ; troublesome sensations, as 
dragging and tension, pressure and boring ; the so- 
called hysteric ball (where patients have the sensation 
of a ball or something similar moving from the epi- 
gastrium upwards towards the throat); pains in any 
of the thoracic and abdominal viscera (caused by the 
affection of the respective nervous plexus or of indi- 
vidual nerves), especially a sensation as of tearing 
and (to be hereinafter again mentioned) uterine pains, 
not unfrequently the point of origin of the whole 
series of nervous phenomena, that manifest them- 
selves principally as spasms of some or others of the 
muscles and as neuralgia in parts often very remote. 

Electricity, galvanic as well as faradic — directed 
partly to the nervous centres and partly to the peri- 
phery — here renders pre-eminent services ; it is 



46 TREATMENT OF 

especially electro-cutaneous irritation by means of the 
electric scourge that sometimes gives almost instant 
relief. 

There exists scarcely any disagreeable sensation 
that has not been experienced at some time or other 
by nervous females, and the most fertile imagination 
can hardly approach reality in this respect. Sensory 
delusions (so-called " false sensations "), hyperere- 
thism, that often manifests itself in the most peculiar 
and disagreeable manner, are, in addition to pareses, 
paralyses, spasms, anaesthesias (as already men- 
tioned), of frequent occurrence. Sometimes the fur- 
ther development of such phenomena brings with it 
disturbance of a psychical nature ; conditions arise 
that exhibit now the character of depression, and 
again (in contradistinction to these) that of exalta- 
tion. Even in these aggravated cases I have re- 
peatedly succeeded, by electrical treatment of the sym- 
pathetic system, in obtaining considerable improve- 
ment and sometimes a complete cure. Thus I call 
to mind the case of a French lady, a teacher of lan- 
guages (in the ambulatorium.of my division), who was 
afflicted with melancholy to such a degree that she 
had repeatedly manifested the intention to commit 
suicide. But few applications of electricity were 
requisite to completely remove the affection. 



NERVOUS DISEASES. 47 

I cannot refrain from observing on this occasion 
that, as far as anything may be expected at all from 
any course of treatment in so-called diseases of the 
mind, electricity appears justified in laying claim to 
special consideration in this respect. 

Of irritable conditions of individual nerves I will 
cite none but hyperesthesia of the auditory nerve, 
that which is known as nervous tingling of the ears. 
In this affection, which in its more aggravated forms 
often become fairly agonizing, galvanic as well as 
faradic electricity may be employed. 

I come now to speak of a form of disease which 
presents to the electric current a fertile field of use- 
fulness ; I refer to migraine or nervous headache 
(liemicranid). It were superfluous to enter more 
minutely into the phenomena which mark this affec- 
tion, which, by reason of its great frequency, is 
universally familiar, and which, by the intensity and 
obstinacy of its attacks, has driven many a patient to 
despair. To this may be added that in migraine the 
entire materia medica deserts us to a certain extent, 
limiting the treatment in most of the cases to rest in 
a darkened chamber, cold fomentations, the adminis- 
tering of black coffee, etc. Here then electricity is a 
true specific ; one which when used in a proper man- 
ner, rarely fails to assert its brilliant efficacy. I 



48 TREATMENT OF 

usually have recourse to electrical treatment of the 
sympathetic nerve, and can point to exceedingly 
favorable results in hospital as well as private prac- 
tice. From among the large number of cases I will 
cite only three, that were referred to me for electrical 
treatment by privy-councillor von Widerhofer. The 
first of these was the case of a young lady, in whom 
the most violent attacks of headache occurred in so 
persistent a form as to engender the suspicion of 
tuberculous disease of the membranes of the brain. 
The migraine was removed by a few electrical appli- 
cations. 

The two other cases were those of the Prin- 
cess of and her daughter aged ten years ; 

which latter case I cite particularly in view of its 
fitness to illustrate the beneficial effects of electricity 
in the migraine of childhood. 

This is the proper place also to make mention of 
one of the most tormenting of affections, namely, 
sleeplessness {agrypnid). In this respect also we 
possess in galvanic electricity a highly valuable 
remedy, which in many respects deserves the pref- 
erence over morphia and hydrate of chloral. 

I will add here a few words on neuralgic condi- 
tions, a class of affections which, when (as is fre- 
quently the case) of a severe and obstinate character, 



NERVOUS DISEASES, 49 

is calculated to drive both the physician and the 
patient to despair. Whoever has had occasion to 
observe even a single attack of violent facial neural- 
gia, will not look upon this assertion as extravagant. 
It appears self-evident that under these circumstances 
we welcome any and every remedy that brings with it 
a cure, or even alleviation, and thus galvanic as well as 
faradic electricity appear of pre-eminent value in the 
treatment of this terrible disease. 

In the electrical treatment of tic douloureitx (the 
facial pain of Fothergill, neuralgia of the fifth pair), 
I have had occasion to observe favorable results 
from various modes of electrical applications. Thus, 
in a case that was sent by Prof. Billroth to my divi- 
sion in the hospital, from the descending constant 
galvanic current ; in another case of the most violent 
bilateral facial pain, from galvanic treatment of the 
sympathetic nerve ; in several other cases from fara- 
dic currents, etc. 

In the tormenting attacks of intercostal neuralgia, 
electro-cutaneous irritation by means of the electric 
scourge was attended with the happiest results ; the 
same was the case in lumbo-abdominal neuralgia. 
Neuralgia of the arms and of the legs (sciatica) 
are likewise wont to disappear rapidly on electro- 
cutaneous irritation. I have thus not unfrequently 

4 



So TREATMENT OE 

been able to remove the so-called " Hexenschuss " in 
a short time. 

The exceedingly painful neuralgia of the cardie 
plexus, whose attacks are often accompanied by the 
most vehement phenomena, so as sometimes to put 
the patient into a state of great excitement and fear, 
were repeatedly abrogated by electricity. 

I come now to the discussion of some forms of 
disease, whose connection with the nervous system 
has only of late been partly established — in some 
respects not at all or at least not with desirable 
accuracy — in which, however, electricity has rendered 
exceedingly valuable service, so much so as to merit 
at least a brief notice in this connection. 

First among these diseases stand gout and rheu- 
matism. The mere mention of the names of these two 
diseases, both of such very frequent occurrence, and 
often so excessively painful, and paralyzing all action, 
is sufficient to make us estimate properly the import- 
ance of any remedy from which we may, more or less 
reasonably, expect to obtain relief. Now, even though 
it be true that (up to the present at least) there is no 
method of treatment guaranteeing certain relief, we 
are yet justified in asserting that electricity belongs 
among the remedies that exhibit the greatest degree 
of efficacy in the affections under consideration, and 



NERVOUS DISEASES. 51 

by means of which we would obtain still more favor- 
able results, were it not that the electric current is 
sometimes called into requisition only after all practi- 
cable and impracticable drugs and domestic remedies 
have proven useless. Recent cases of rheumatism, 
readily yield to galvanic and faradic electricity. Thus 
I cured a rather severe case of muscular rheumatism 

occurring in the person of the Prince of (a 

patient of privy-councillor the Baronet von Loesch- 
ner) in a very few sittings. But inveterate and 
neglected cases also of gout and rheumatism are 
often relieved or cured by electricity; nor does it 
matter whether the affection be articular or muscular. 
The most remarkable instance of the well-nigh mi- 
raculous remedial power of the electric current I 
witnessed in the case of a gentleman between fifty 
and sixty years of age, sent me for electrical treat- 
ment by privy-councillor Professor Helm, who, 
tormented by severe gout in the swollen joints of the 
knee, shoulder, elbow, hands and fingers, was scarcely 
able to move, had already employed all possible 
spring-waters and drugs in vain, and yet, after he had 
given up all hopes of being cured, was, by the employ- 
ment of electricity, enabled to walk to his oifice and 
there to write. This is one of the most brilliant cases 
that has come under my observation ; the multitude 



52 TREATMENT OF 

of others in which favorable, often astonishing results 
have been obtained, is too great to cite individual 
ones. 

In acute articular as well as muscular rheumatism, 
electricity is also, so far as my experience goes, a 
very valuable remedy, when the first violent symp- 
toms have abated somewhat ; and it should be made 
a general rule to lose no time in gout or rheumatism, 
but to initiate electrical treatment as early as possible, 
the results of which will, in the majority of cases, 
certainly be very satisfactory. 

The paralyses or muscular spasms and contractions 
that sometimes remain after rheumatism or occur 
synchronously with this, are likewise, as already 
observed heretofore, best treated by means of elec- 
tricity. 

As in the articular affections of a rheumatic or 
gouty nature, so also we find that in other articular 
affections, especially the so-called traumatic arthrites 
and articular swellings, occasioned by external 
injuries (blow, thrust, bruise, fall, etc.), we possess in 
electricity an excellent remedy, to employ which we 
should delay the less, in that not only incurable 
changes may take place within the joint itself, but 
more or less complete paralysis of the neighboring 
muscles is wont to supervene. Inflammations of 



NERVOUS DISEASES. 53 

muscles and tendons as well as their sequelae are 
also best treated by electricity, under the use of which 
effusions and other inflammatory products have re- 
peatedly been caused to disappear. 

The treatment of Basedow's disease, which is char- 
acterized by enlargement of the thyroid gland (known 
as "goitre"), palpitation of the heart and exophthalmic 
goitre, and which is no doubt dependent on an 
affection of the sympathetic nerve, is most efficiently 
and rationally conducted by means of electricity, 
from the proper employment of which we are justified 
in anticipating the most satisfactory results. The 
more immediate effect is usually a moderation of the 
excessive cardiac action and a discontinuance of the 
palpitations, which are followed by the disappearance 
of the remaining and very irksome and sometimes 
fear-inspiring symptoms. 

This would appear a fitting place to remark that 
those cases also of enlargement of the thyroid gland 
in which the other symptoms of Basedow's disease 
are wanting, where thus we have to do with simple 
"goitre" are frequently brought to a rapid cure by 
the use of electricity. The mode of applying the 
remedy varies, the galvanic current being employed 
in some cases, the faradic in others. 

As I have already stated in my hand-book of 



54 TREATMENT OF 

electro-therapeutics, I have succeeded repeatedly in 
curing cases of intermittent fever by electrical treat- 
ment of the sympathetic nerve, and I have at the 
present time frequent occasion to treat intermittents 
in the manner indicated. In the majority of these 
cases no quinia at all had been taken ; the influence 
of change of locality was likewise excluded, the 
patients becoming affected in Vienna and surrounding 
places, and remaining there after their recovery. In 
those cases where the electrical treatment had been 
preceded by the use of quinia, the latter had re- 
mained unsuccessful. Enlargements of the spleen 
likewise disappeared under the use of the electric 
(faradic) current. In this respect great interest 
attached to an aggravated case of intermittent fever 
with considerable splenic enlargement occurring in 
the person of a colleague, who acted as operating 
surgeon in Billroth' s clinique, and was attended by my 
assistant Dr. von Mertens. From sitting to sitting 
the attacks of the intermittent fever became dimin- 
ished and the splenic enlargement decreased, without 
the place of abode being changed, or any anti-febrile 
medicine taken. 

The pre-eminent efficiency of electricity in artic- 
ular swellings of every kind has already been pointed 
out ; it remains only to call attention to the invalua- 



NERVOUS DISEASES. 55 

ble effects of the electric current in the removal of 
tumors generally. There is scarcely a tumor of any 
kind that cannot be removed by means of electricity. 
The mode of applying the current is here mainly of 
two kinds ; where the tumor is capable of being 
absorbed, the ordinary manner of application will 
suffice ; where, however, we have to do with tumors 
that are not absorbable, what is known as the electro- 
lytic treatment (by means of acupuncture) is to be 
instituted. I have in this respect frequently obtained 
excellent results, and seen the tumors disappear 
rapidly under the influence of the electric current, as 
in the case of a lingual cancer, almost the size of a 
walnut (a patient of Prof, von Sigmund), in a single 
sitting. At all events this treatment offers us the 
not inconsiderable advantage of dispensing with the 
use of the knife or a candescent instrument, and thus 
sparing the patient the occasion for frequently great 
anxiety. 

Strictures of the" urethra also belong among the 
forms of disease in which much has already been 
done by means of the electrolytic effects of the cur- 
rent. The employment of electricity in this affection 
is practised more particularly in France, and the 
results are often the most satisfactory. 

In dwelling on the manifold affections that we meet 



S 6 TREATMENT OE 

with in nervous women, I have already found occa- 
sion to point to the connection of such affections 
with disease of the female genital organs, and it is 
almost unnecessary for me to observe how important 
it appears for the cure of the nervous trouble to 
remove the "female disease" with which this is con- 
nected. 

In pain of the uterus (hysteralgia), it frequently be- 
comes possible by means of the electric current to 
obtain not only a mitigation of the pain, but its entire 
abrogation. In especially persistent cases with 
violent symptoms, I sometimes combine with the elec- 
trical treatment intra- uterine injections of a solution 
of morphia, by means of a syringe which is con- 
structed similarly to that employed for subcutaneous 
injections, and which with the aid of a speculum can 
readily be brought to the vaginal portion. 

Disturbances before, during or after menstruation, 
or the non-occurrence of the menstrual flow (where 
not the results of constitutional anomalies or serious 
structural changes of the organ), are likewise treated 
most successfully by electricity. The current is ap- 
plied either directly to the womb (which is an abso- 
lutely painless procedure) or is employed externally as 
an electro-cutaneous irritant in the neighborhood of 
the genitals. Electrical treatment of the uterus can 



NERVOUS DISEASES. 57 

sometimes be employed advantageously also in dis- 
placements (versions, flexions, etc). 

In the case of a patient in my division, whose 
uterus did not diminish in a normal manner after par- 
turition, the use of the faradic current brought about 
the desired contraction and diminution of the uterus 
in a short time. That the electric current, even 
when applied externally to the abdominal walls, pro- 
duces energetic uterine contractions, and thus ma- 
terially hastens delivery where this is retarded by 
deficient uterine action, has been known for a long 
time. 

I have made interesting experiments with galvan- 
ism in old neglected cases of leucorrhoea, where the 
zinc pole actually exercised a favorable influence on the 
mucous membrane of the vagina. This is the more 
easy of explanation, since we can obtain from a strong 
galvanic current very energetic astringent effects 
which certainly surpass those of alum, tannin, etc. If 
the strength of the current be still further increased, 
the effects obtained will be caustic. By cauterization 
with the galvanic current I have also repeatedly suc- 
ceeded in curing ulcerating surfaces of the skin in 
various regions. Thus I recollect an ulcer of the 
lower leg somewhat larger than a hand, in the person of 
a man otherwise healthy, which by electric cauteriza- 



5 8 TREATMENT OF 

tion was in a brief space of time reduced to one third 
its original size. 

Hyperesthesia of the vagina, which in some of the 
cases that have come under my observation was so 
intense that even the slightest touch of the genitals 
could not be borne by the patient, I have repeatedly 
seen to diminish and disappear under the influence of 
the electric current. It is only necessary here to 
operate by means of mild currents, which are very 
easily borne, while strong currents have an irritant 
rather than a soothing effect. 

The remedial power of electricity in laryngeal af- 
fections of almost every nature is no less than in the 
forms of disease already mentioned. The electrical 
treatment of paralyses of the vocal cords which bring 
in their train partial or complete loss of voice, has 
already been touched upon (page 29) ; it remains ne- 
cessary, then, to make mention only of one more pro- 
cedure, which has been recently introduced by me 
among the methods of intra-laryngeal treatment, and 
may be looked upon as probably the most important 
advance in the treatment of laryngeal affections that 
has been made in Vienna since the death of Professor 
Turck. 

I have reference to the process, by means of the 
chemical decomposing effects of the electric current 



NERVOUS DISEASES. 59 

(electrolysis), of dispersing intra-laryngeal tumors, 
without, as was formerly the case, necessitating the 
introduction into the larynx of candescent or cutting 
instruments. Irrespective of the fact that the in- 
troduction of such instruments necessitates consid- 
erable and troublesome preparations, it becomes 
hazardous for the reason that the slightest, frequently 
unavoidable involuntary movement, coughing, deglu- 
titory movements, etc., may be attended with very 
serious consequences, amounting sometimes to the 
permanent loss of voice (through injury of the vocal 
cords). In this respect the procedure introduced by 
me into practice offers very material advantages,* and 
the new instruments as suggested by me have already 
received the attention of numerous physicians. 

In strictures of the larynx and of the trachea it 
is also expedient to utilize the electrolytic force, and 
in many cases it is possible in this w^ay to counteract 
the attacks of dyspnoea that occur sooner or later. 
For this purpose also I have constructed a special in- 
strument ; likewise one for the cure of longitudinal 
rents of the vocal cords by means of the caustic effect 
of the electric current. 



* Further particulars on this subject can be found in my treatise : 
" On a new and safe process for the removal of laryngeal tumors." 
{Vienna, 1872, Carl Czermack.) 



60 TREATMENT OF 

I have endeavored in the foregoing lines to pre- 
sent a brief resume of those forms of disease in which 
electricity has actually been employed with success. 
Copious as this abstract may seem, and numerous as 
may be the affections that in consequence would ap- 
pear to come within the domain of electro-therapeu- 
tics, the foregoing catalogue of these yet does not 
even remotely lay claim to completeness. I have my- 
self instituted manifold experiments with the electric 
current that have found no place here, and the same 
is true of many experiments made by others, which I 
could not as yet regard as sufficiently ripe for promul- 
gation. At all events, even the foregoing list will 
serve to give the reader an idea of the grand enrich- 
ment of therapeutics by the rational employment of 
electricity. 

In reference to the number of clinical observations 
mentioned in the beginning of these lines, as being at 
my disposal, I take this opportunity of saying a few 
words relative to what is being done in the special 
division * of our K. K. General Hospital, intended 
for the reception of diseases of the nervous system, 
chest and throat. Irrespective of the fact that the 

* The official title, as is well known, is " Division for electrothe- 
rapy and inhalations," in accordance with the two therapeutic methods 
principally employed there. 



NERVOUS DISEASES. 61 

beds of the division were, with few exceptions, almost 
constantly occupied, so much so that patients who de- 
sired admission could not be at once admitted for lack 
of room, the out-door department of the division for 
the free treatment of cases of nerve, chest, and throat 
diseases was, during the past year alone, taken into 
requisition by three thousand three hundred and 
eighty-three patients. As nearly all of these patients 
suffered from chronic diseases, and their treatment 
frequently required several weeks, an average number 
of from twelve to fifteen ordinations for each patient 
appears rather too low than too high an estimate ; 
whence it follows that in addition to the treatment of 
the patients cared for in the hospital itself, from forty 
to fifty thousand applications were given in my 
division in the course of one year. In this I recog- 
nize the most conclusive proof of the high degree of 
confidence had by my colleagues as well as the suf- 
fering portion of the public in the method of thera- 
peutics practised by me, and in the results already 
obtained I find the best guarantees for future useful- 
ness. 



INDEX. 



Agrypnia, 48. 
Anaesthesia, 42. 
Anosmia, 43. 
Asthma, nervous, 41. 

B 

Basedow's disease, 53. 
Brain, electrization of, 19. 



Chorea, 37. 
Constipation, 33. 
Contractions, tonic, 38. 



Electricity, misapplication of, 9. 

indications for, 12. 

prejudices against, 13. 
Electrization, pain from, 32. 
Electro-therapeutics, progress of, 

6. 
Enuresis nocturna, 35. 
Epilepsy, 36. 

F 

Facial neuralgia, 49. 
paralysis, 28. 



Goitre, 53, 
Gout, 50. 



H 



Hemicrania, 47. 
Hyperaesthesiae, 44. 
Hysteralgia, 56. 
Hysteria, 25. 
Hysterical paralysis, 26. 
spasms, 39. 

I 

Impotency> 43. 
Insomnia, 48. 
Intermittent fever, 54. 



Laryngeal affections, 58. 
Leucorrhcea, 57. 
Locomoter ataxia, 20. 

M 

Melancholia, 46. 
Migraine, 47. 
Mimic spasms, 40. 
Muscular atrophy, 35. 



6 4 



INDEX. 



N 

Neuralgias, 48. 
Neuralgia, hysterical, 45. 



O 

Orthopaedic affections, 35. 



Paraesthesiae, 42. 
Paralyses, 17. 
Paralysis from 

Acute constitutional diseases, 
24. 

Chronic Poisoning, 23. 

Osteo-malacia, 24. 

Rhachitis, 24. 

Scrofula, 24. 

Syphilis, 24. 
Paralysis of 

Bladder, 34. 

Muscles of eye, 26. 

Muscles of larynx, 29. 

Tongue, 29. 
Paralysis, facial, 28. 
Pareses, 17. 
Paresis Oesophagi, 31. 
Peripheral paralyses, 26. 



Progressive Muscular Atrophy, 21. 
Pulmonary tuberculosis, 33. 

R 

Rheumatism, 50. 



Sensation, disturbances of, 42. 
Spasmodic affections, 36, 41. 

rheumatic, 48. 
Spasms, chronic, 38. 
Spinal paralyses, 19. 
Strictures, urethral, 55. 



Tabes dorsualis, 20. 
Tic douloureux, 49. 
Tinnitus Aurium, 47. 
Torticollis, 40. 
Tumors, 55. 

U 
Uterine diseases, 56. 

W 

Writer's spasm, 40. 



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